<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Strict//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-strict.dtd">
<html xmlns="http://www.w3.org/1999/xhtml" xml:lang="en" lang="en">
	<head>
		<? wbs_initLayout ?>

	</head>
	<body onLoad="autoFocusFormControl( '<? $invalidField ?>', 'trialdata' )">
		<? wbs_pageLayout ?>
			<? wbs_errorBlock ?>

			<? if !$fatalError ?>

				<? if !$done ?>
					<? wbs_note smallFont=false displayNoteMarker=false ?><? $kernelStrings.rt_form_title ?><? /wbs_note ?>

					<? wbs_formLayout caption=$pageTitle ?>
						<? wbs_formContent ?>
								<tr>
									<td><? wbs_label for="company" fieldName="company" text=$kernelStrings.rb_company_label ?></td>
									<td><input name="trialdata[company]" type="text" id="company" class="FormControl" value="<? $trialdata.company|htmlsafe:true:true?>" size="50" maxlength="255"/></td>
								</tr>
								<tr>
									<td><? wbs_label for="firstname" fieldName="firstname" text=$kernelStrings.rb_firstname_label ?></td>
									<td><input name="trialdata[firstname]" id="firstname" type="text" class="FormControl" value="<? $trialdata.firstname|htmlsafe:true:true?>" size="50" maxlength="50"/></td>
								</tr>
								<tr class="SeparatedRow">
									<td><? wbs_label for="lastname" fieldName="lastname" text=$kernelStrings.rb_lastname_label ?></td>
									<td><input name="trialdata[lastname]" id="lastname" type="text" class="FormControl" value="<? $trialdata.lastname|htmlsafe:true:true?>" size="50" maxlength="50"/></td>
								</tr>
								<tr>
									<td><? wbs_label for="email" fieldName="email" text=$kernelStrings.rb_email_label ?></td>
									<td><input name="trialdata[email]" id="email" type="text" class="FormControl" value="<? $trialdata.email|htmlsafe:true:true?>" size="50" maxlength="50"/></td>
								</tr>
								<tr>
									<td></td>
									<td><? wbs_note width="300px" displayNoteMarker=false ?><? $kernelStrings.rb_email_note ?><? /wbs_note ?></td>
								</tr>
						<? /wbs_formContent ?>

						<? wbs_formButtonsPanel ?>

							<? wbs_buttonSet ?>
								<? wbs_buttonSetButton caption=$kernelStrings.rb_submit_btn name="savebtn" ?>
							<? /wbs_buttonSet ?>

						<? /wbs_formButtonsPanel ?>

					<? /wbs_formLayout ?>

					<? wbs_note ?><? $kernelStrings.rb_submit_note ?><? /wbs_note ?>
				<? else ?>
					<? wbs_formCaption text=$kernelStrings.rb_greeting|cat:" "|cat:$trialdata.firstname|cat:" "|cat:$trialdata.lastname|cat:","|htmlsafe:true:true ?>
					<? wbs_note smallFont=false displayNoteMarker=false ?><font color="red"><b><? $kernelStrings.rb_done1_label ?></b></font><? /wbs_note ?>
					<? wbs_note smallFont=false displayNoteMarker=false ?><? $kernelStrings.rb_done2_label|cat:" " ?><b><? $trialdata.email|htmlsafe:true:true ?></b><? /wbs_note ?>
					<? wbs_note smallFont=false displayNoteMarker=false ?><? $kernelStrings.rb_done7_label ?><? /wbs_note ?>

					<? wbs_hr width="500px" ?>

					<? wbs_note smallFont=false width="500px" ?>
						<? $kernelStrings.rb_done3_label ?>
						<ol class="List">
							<li><? $kernelStrings.rb_done4_label ?></li>
							<li><? $kernelStrings.rb_done5_label ?></li>
						</ol>
					<? /wbs_note ?>
					<? wbs_note smallFont=false displayNoteMarker=false ?><? $kernelStrings.rb_done6_label ?><? /wbs_note ?>
				<? /if ?>

			<? /if ?>

		<? /wbs_pageLayout ?>
	</body>
</html>